This prospective study aimed to evaluate how continuous glucose monitoring (CGM) use affects the Glycemic Management Indicator (GMI), which reflects estimated HbA1c, average blood glucose, and time in range (TIR) in patients who require multiple insulin injections—primarily those with Type 2 diabetes—and includes one patient with Type 1 diabetes mellitus. The main goal of the project was to assess the role that Internal Medicine Residents play in CGM management after initial education and subsequent supervision by an endocrinologist in a General Internal Medicine residency clinic. This approach has never been implemented in Internal Medicine residency clinics in the USA. If successful, our goal is to expand to other Internal Medicine residency programs across the USA and, eventually, to integrate it into the Internal Medicine residency curriculum as an ACGME requirement for the education of our Internal Medicine Residents. As we know, the current Standards of Care, per ADA in 2025, require the implementation of CGM not only in specialized Endocrine clinics but also in General Internal Medicine clinics. Here, we are taking a step further and have introduced CGM for the management of Diabetes Mellitus in the Internal Medicine Residency clinic.  Patients were recruited from the Internal Medicine Residency Clinic. Eligibility criteria included an initial HbA1c level between 7% and 14%, self-monitoring of blood glucose (SMBG) four times daily, and qualification for use of a CGM device.  Additionally, the study includes patients with Diabetes Mellitus who use three to four daily insulin injections, with or without other diabetic medications. After appropriate education by a board-certified endocrinologist, internal medicine residents remotely monitor patients who transition from SMBG to CGM. Patients share their CGM data with the Internal Medicine Clinic. Participants are contacted every two weeks by their designated resident physician via telephone and seen bi-monthly in the clinic by members of the CGM team. All residents work under the supervision of a board-certified endocrinologist, who oversees the project and is also part of the clinic. The study is planned to last 24 months. Currently, we have 4 months of data from 24 patients, providing insight into patient outcomes to date. The data show that after switching from SMBG to CGM, the GMI decreased from 9.92% to 7.74% at the 2- and 4-month marks. The average blood glucose decreased from 275 mg/dl to 176 mg/dl, and the TIR increased from 30% to 57%. The major improvement in Diabetes Mellitus control occurred mainly in the first 2 months after the switch from SMBG to CGM.

Andrey Manov is a Certified Endocrinologist and Internist by ABIM in the USA and in the European Union. Have 34 scientific publications in Peer-Reviewed Journals in the area of DM type 1 and Type 2 pathogenesis, treatment, Thyroid disorders, etc., and have been the lead investigator in 2 International Multicenter scientific trials. Worked in England with the lead World Renowned Immuno -endocrinologist Prof. Franco Bottazzo. In London, England, in 1991, the increased expression of the adhesion molecule CD 44 on snap frozen sections and cell cultures in different autoimmune thyroid diseases. Interested in general endocrinology and Diabetology with significant teaching experience and clinical experience. Have been an Academic Faculty member for 23 years in different hospitals and Universities in Fort Worth, Texas, and Dallas, Texas, at a level of Associate and Full Professor. Was a Course Director for Endocrinology for 2-nd year Medical Students in the University of North Texas Health Science Center /UNTHSC/, Fort Worth, TX -2017-2018 at a level of Professor. Currently, He is a Professor in the Department of Medicine in TCU and UNTHSC School of Medicine, Fort Worth, TX, since 2017. He was elected as a Fellow of the American College of Internal Medicine and as a Top Doctor Internist for 2018 in Fort Worth, TX.